...with traditional Medicare Providers need to confirm the CareSource MyCare Ohio member’s option for Medicare coverage. Important Tools Provider Portal Member ID Card You can easily verify member eligibility by...

...our endorsement. Finding Care and Your Rights Find Providers Find LGBTQ+ affirming providers. They know and understand the needs of LGBTQ+ people. Not all the providers listed are in our...

...nurses through our 24-Hour Nurse Advice Line. No-cost, 24-hour telehealth care providers through Teladoc®. No-cost telehealth mental health and substance use disorder counseling through Teladoc, 7 a.m. to 9 p.m....

...access the care they need. Coordinating Integrated Care Coordinated care is key to ensuring optimal outcomes for our members. We ensure our providers have access to behavioral health resources and...

Our Program Integrity Department handles cases of managed care fraud, waste or abuse. It can be done by providers, pharmacies, or members. Fraud means the purposeful misuse of or for...

...at 1-800-488-0134 or visit https://www.caresource.com/providers/ for instructions. Error Number: 132 Error Description: Missing/Invalid Medicaid ID for Atypical Provider How to Fix: Ensure correct Medicaid ID is provided. Error Number: 187...

Providers are expected to deliver services in a culturally competent manner, which includes removing all language barriers, accommodating the unique ethnic, cultural and social needs of the member and understand...

...non-contracted providers as Medicare would have paid for the same service. Non-contracted providers have the right to request a reconsideration of the plan’s denial of payment: Non-contracted providers have 60...

...Providers may not charge members for services which CareSource PASSE™ denied based on lack of medical necessity or lack of compliance to contractual terms. Providers may not bill members for...

...Excellent Accreditation Compliance with NCQA accreditation standards High level of Healthcare Effectiveness Data and Information Set (HEDIS®) performance High level of Consumer Assessment of Healthcare Providers and Systems (CAHPS®) performance...